Major coagulation disorders and parameters in COVID-19 patients

Abstract

Coronavirus disease 2019 (COVID-19), with a high prevalence rate, has rapidly infected millions of people around the world. Since viral infections can disrupt the coagulation and homeostasis cascades, various inflammatory and coagulation problems occur due to COVID-19 infection, similar to coronavirus epidemics in 2003 and 2004. According to multiple previous studies, in the present research, we reviewed the most commonly reported problems of COVID-19 patients, such as venous thromboembolism, pulmonary embolism, disseminated intravascular coagulation, etc. and investigated the causes in these patients. Coagulation and inflammatory markers, such as platelets and fibrinogen, C-reactive protein, lactate dehydrogenase, d-dimer, prothrombin time, etc., were also discussed, and the treatment options were briefly reviewed. In addition to coagulation treatments, regular examination of coagulation parameters and thrombotic complications can be helpful in the timely treatment of patients. Therefore, it is helpful to review the coagulation problems in COVID-19 patients. Although all mentioned problems and markers are important in COVID-19, some of them are more valuable in terms of diagnosis and prognosis.

Alteraciones hematológicas como consecuencia de COVID-19 y sus vacunas

“…Existen marcadores para ayudar a comprender la gravedad de la trombosis en pacientes con COVID-19, tales como los niveles elevados de dímero D, FVW, factor VIII, TP, fibrinógeno y anticuerpos antifosfolípidos, o niveles bajos en el recuento de plaquetas y ADAMTS-13 [24,26]. Por otra parte, el estado hiperinflamatorio se ha asociado con niveles elevados de marcadores como interleuquinas, interferones, TNF-α, quimiocinas y otros mediadores que se han relacionado con la gravedad de la enfermedad (tabla 1) [24].…”

“…Se ha encontrado que la relación plaquetas/linfocitos ha sido un factor influyente en la duración de la enfermedad en pacientes graves con COVID-19, y se sugiere una posible correlación entre este índice y la tormenta de citoquinas asociada a la prolongación de los días de hospitalización [9,26]. Se ha observado que hay un aumento del triple de la mortalidad y peor pronóstico en pacientes con trombocitopenia [20], que puede resultar de la sobreactivación y el desgaste de plaquetas asociado con trombosis [27].…”

Evaluation of Blood Coagulation by Optical Vortex Tracking

“…The coagulation system is the body's defense mechanism for maintaining normal blood flow and preventing blood loss [1][2][3]. Its abnormality can result from a multitude of conditions such as severe trauma, hypothermia, or surgery, and it can induce coagulopathy, including thrombocytopenia, subcutaneous hemorrhage, atherosclerosis, and even life-threatening bleeding [4][5][6][7]. The normal coagulation process depends on a delicate dynamic balance between coagulation, anticoagulation, and fibrinolysis [2][3][4].…”

“…However, coagulation is a cascade of complex biochemical processes involving interactions between platelets, red blood cells, and over a dozen coagulation factors, as well as two distinct coagulation pathways-endogenous and exogenous [8][9][10]. Conventional coagulation tests (CCTs) generally assess the coagulation status of patients by measuring the activated thromboplastin time (aPTT), prothrombin time (PT), platelet count (PLT), and fibrinogen levels, which require much time to separate plasma, platelets, and other components from whole blood [5][6][7]. Thus, traditional tests are not efficient enough to obtain the coagulation results, and the results are limited to coagulation parameters at a specific moment in time, which do not reflect the whole dynamics process of coagulation.…”

Evaluation of Covid-19-Associated Hypercoagulability with Functional Coagulation Assays and Extracellular Vesicles

“…The virus penetrates endothelial cells, lymphocytes and pneumocytes, the main target cells of SARS-CoV-2, by binding to angiotensin converting enzyme (ACE)-2 receptors on their surfaces 3 . COVID-19-associated coagulopathy (CAC) is characterized by an activation of the coagulation resulting in both a hypercoagulable state and hypocoagulability the latter due to markedly increased consumption of platelets and coagulation factors [4][5][6] . Traditional coagulation assays in patients with CAC show elevated levels of D-dimer (most severe cases), Factor VIII (FVIII) and Von Willebrand Factor (VWF).…”